How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | None | $64.57 | $67.61 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
BCBS Arkansas Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $138.04 | Professional | None | $104.71 | $114.82 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $100.00 | Facility | None | $77.62 | $77.62 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $77.62 | Professional | None | $43.65 | $56.23 | $77.62 |
Qualchoice Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
United Setting Facility Modifier None Typical Low $60.26 Median $141.25 Typical High $165.96 | Facility | None | $60.26 | $141.25 | $165.96 |
United Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $91.20 | Professional | None | $46.77 | $60.26 | $91.20 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.18 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $6.76 |
Where Arkansas sits
The same service costs 3.1 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arkansas· 15th of 51
$105
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.